ELY, ROBBIE LYNN - Licensee Information

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Last Update: Saturday, April 20, 2024 4:03 AM CDT
Next Update: Saturday, April 20, 2024 12:00 PM CDT

ELY, ROBBIE LYNN

Practice Address:	ACTIVE LIFESTYLE MEDICAL LLC 5455 S MINGO RD, STE E TULSA OK 74146 Address last updated on 1/6/2023
Phone #:	(918) 576-6765
Fax #:
County:	TULSA
License:	138
Dated:	2/1/2013
Expires:	1/31/2025
License Type:	Licensed Pedorthist
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	0

Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.

All information below is entered by the licensee but not verified by the Oklahoma Medical Board.

Locations:	Hours:	Languages:
ACTIVE LIFESTYLE MEDICAL LLC 5455 S MINGO RD, STE E TULSA OK 74146 Phone #: (918) 576-6765 Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisees(s):
KELLY DAWN WATKINS	LPED	169

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Oklahoma State Board of Medical Licensure and Supervision :: 101 NE 51st St, Oklahoma City, OK 73105-1821
Main Number: (405) 962-1400 :: Fax: (405) 962-1440 :: Complaints outside 405 area code: 1-800-381-4519
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